This entry first appeared at Mad in America on March 8, 2014.
The safety of our children is a sacred obligation we strive to preserve. Anything or anyone that harms them becomes the object of our distrust and potential wrath.
I want to raise the possibility that psychiatry, for all its accomplished champions like Thomas Insel of the NIMH, may have forgotten the elemental fear people feel for the safety of their children. If psychiatry becomes perceived as a consistently increasing threat to our children, then are its days as a monolithic social institution numbered?
This essay was prompted when I recently had a pronounced visceral reaction of repulsion as I read about dozens of young children being subjected to new MRI brain scan research. Many friends that I shared this research with had a similarly strong negative reaction. The NIMH-supported research article, “Disrupted Amygdala Reactivity in Depressed 4- to 6-Year-Old Children,” was reported in the Journal of the American Academy of Child and Adolescent Psychiatry. The two experimental groups were described as “… depressed 4- to 6-year-old children and their healthy peers.”
The pathologizing process of diagnosing and labeling a 4-year-old child as being a clinically depressed research subject and therefore unhealthy compared to their peers, is done with the assumption that making that medical diagnosis is in the best interest of the child.
It is harmful to assume something is wrong with a young child’s brain when there is no doubt ample evidence that something has happened or is happening in the child’s life, that is causing them distress, to say nothing about the negative effects of a child receiving a DSM identity-transforming diagnostic label and being officially categorized as an exceptionally young mental patient.
Plus, what does a doctor tell a 4-year-old child before the MRI machine starts? “Please hold very still now, because we need to find out if there is something wrong with your brain.”
The children in this research on depression were also described as being “medication-naive.” None of them had been on medications – yet. If the word “naive” was instead used to mean that the children were innocent, then that would be accurate because a 4-, 5-, or 6-year-old child is indeed innocent and is helplessly at the mercy of the adults who decide what happens to them.
For over 30 years, I’ve known and worked alongside many child psychiatrists. They are some of the most dedicated and caring people I have ever known. When I would repeatedly protest to them about the dangers of prescribing antipsychotic meds and SSRI’s to children and teens, the psychiatrists often, with true anguish would respond to me by saying, “But Michael, I have to do it! The latest brain imaging research says that psychosis damages the brain, and it has been shown that depression is caused by a lack of serotonin.”
The solid, peer-reviewed research I would then offer, attempting to counter their biochemical, genetic-based, disease model beliefs, would unfortunately not be taken seriously enough to change my psychiatrist coworkers’ minds.
To no avail, I would urge them to consider that valuable scientific inquiry in the broader field of psychology doesn’t have to be limited to only studying genetics and the physical human brain. They shunned the evidence proving the efficacy of psychosocial alternatives to psychiatric medications. They seemed compelled to elevate applied neuroscience as a reified paradigm of understanding and treating human psychological distress.
It should be no surprise that almost all psychiatrists continue to believe what they were taught in their medical training, and believe what is affirmed in every journal they read about the future of psychiatry being applied neuroscience, and that they believe what is repeated to them by every drug company rep who frequently visits them with medication samples.
The path seems to be clear ahead for even more research on preschool children’s brains, because NIMH Chief Thomas Insel has a clear vision that he is determined to make happen. When he says, “The future of psychiatry is clinical neuroscience based on a much deeper understanding of the brain,” Dr. Insel means that his five-year plan called the Human Connectome Project, that will build a baseline data base for brain structure and activity using MRI imaging is leaving the DSM era of psychiatry in the dust.
The DSM is an embarrassment for a world class research scientist like Insel. But what he envisions is much more ominous for children and everyone else.
Insel’s leadership at the NIMH has the very strong support of forced treatment advocate, Dr. E. Fuller Torrey, who says of Insel: “He is the best director we have ever had.”
Insel and newly-elected APA President Dr. Jeffrey Lieberman want to preside over a new era of psychiatry where it gains the stature of any other medical specialty based on hard science. Insel and Lieberman want a research-proven genetic and biological basis for psychiatry, to qualify it as a fully functioning and respected clinical neuroscience.
Dr. Lieberman has recently said in The Scientific American, that vocal critics of psychiatry are “Misinformed or misinforming self-interested ideologues and self-promoters who are spreading scientific anarchy.”
Dissidents such as may appear on Mad in America are dismissed as scientific anarchists by the head of the APA, while President Obama and Congress are hugely bankrolling the new NIMH research on the brain.
The dramatic future for psychiatry envisioned by Doctors Insel, Torrey and Lieberman as a golden age of applied neuroscience appears to be assured.
Is psychiatry, as such a powerful monolithic social institution, truly “too big to fail?” Or is there a hidden vulnerability present in the proud edifice?
I wrote a blog here on MIA a couple of years ago called “I Don’t Believe in Mental Illness, Do You?” What that means to me is that I don’t believe in the centuries-long medical model project of pathologizing human emotional suffering that is the hallmark of psychiatry.
The medical model never satisfied my answers about the causes and healings from my own experiences of emotional suffering and madness, or spoke to me as a reliable guide in helping the children and adults I provide therapy for. If I did believe in the medical model, I would surely do what my child psychiatrist friends unintentionally sometimes do – I would risk harming innocent children while truly believing that I am helping them.
What we believe can dictate what we do. But surely our beliefs should not result in children being harmed.
The problem is, that the medical model belief system sets psychiatrists up to be blind to its harmful applications. Psychiatrists who did lobotomies and sterilizations convinced themselves according to medical model tenets, that such harmful procedures were necessary and in the recipient’s best interest. The fact that child psychiatrists in Australia will actually administer ECT to children under 4 years old, and that antipsychotic and antidepressant medications are given to toddlers in the U.S., is dramatic continued proof of how the treatments dictated by a morally numb psychiatric science are still failing to pass the caregiver litmus test of “First, do no harm.”
Blindly failing that ethical test means that psychiatry is clearly in the process of losing the moral authority to deserve our trust, especially as we learn more of how our children are at risk of being harmed.
So, I have come to believe in recent years that Dr. Insel’s vision and the incredible psychiatric social experiment of pathologizing human emotional suffering will ultimately fail, because psychiatry will continue to zealously and blindly cross a morally repulsive line and forget that a great many people will never accept their children and grandchildren being exposed to danger.
I believe that at some point, those continued treatment excesses with our children will finally cause the general public to lose faith in and simply abandon psychiatry, moving on to a new paradigm of care where the growing demands for safe and nonpathologizing alternatives are met.
The obsolescence of psychiatry may not happen in my lifetime, but you will see the tide turn even more in that direction when a first young blogger appears on Mad in America to proclaim, “I was diagnosed with bipolar disorder and put on antipsychotic medications when I was very young. Please understand, I was only four years old when they started injuring me.”
The safety of our children id indeed our sacred obligation. The problem is that children can not give consent. We are their moral guardians and it is up to us to protect them. I fear a world in which government leaves it’s children unprotected.